Descriptive epidemiology of the first wave of COVID-19 in Petaling District, Malaysia: Focus on asymptomatic transmission

@#Background: COVID-19 was first detected in Malaysia on 25 January 2020. Multiple clusters were detected in Petaling District, with the first locally transmitted case reported on 8 February. Descriptive analyses of the epidemiology of the COVID-19 outbreak in Petaling are presented, from the first case to the end of the first wave. Methods: All laboratory-confirmed COVID-19 cases reported to the Petaling District Health Office between 1 February and 26 June 2020 were analysed. Socio-demographic characteristics, symptoms, date of onset, date of exposure, travel history and history of comorbidities were obtained by phone interviews using one of two investigation forms. The descriptive analysis was conducted according to time, place and person. Results: There were 437 COVID-19 cases, for an incidence rate of 24/100 000 population. Ten (2.3%) deaths and 427 recovered cases were recorded. Of the 437 cases, 35.5% remained asymptomatic and 64.5% were symptomatic. Common symptoms included fever (43.8%), cough (31.6%) and sore throat (16.2%); 67.3% had no comorbidities, 62.5% reported close contact with a confirmed case, and 76.7% were local infections. Transmission occurred in four main groups: religious gatherings (20.4%), corporations (15.1%), health facilities (10.3%) and a wholesale wet market (6.4%). In 31.9% of confirmed cases, an epidemiological link to an asymptomatic case was found. Conclusion: Transmission of the disease by asymptomatic cases should be emphasized to ensure continuous wearing of face masks, hand hygiene and social distancing. Further research should be conducted to better understand the transmission of SARS-CoV-2 from asymptomatic cases.

Coloring Narrative Therapy for Hospitalization Patients of Hospice Palliative Care Wards without Special Psychological Test: A Case Report

Art therapy would help end-of-life care who hospitalized in hospice palliative care wards. This case report aims to examineYeonmyeong (Prolongation of life) cure or spontaneous healing and so on have developed over the last 3 years. The case reportprovides an analysis of palliative care through coloring narrative therapy from torture and injection of ill treatment. Significantdevelopments include the following: (1) The older persons who have chronic terminal cancers realize their here and now. (2) Thepatients have terminally accepted their end of life. (3) Their families were greeting adieu with their palliative care clients. InKorea, Yeonmyeong cure is approved by modern society patients and their families. Therefore, medical palliative care groupsare thinking more well-being healing method for human being.

Coloring Narrative Therapy, After Diagnosis of Dementia Stage, without Special Psychological Test for the Adults in Sanatorium: A Case Report.

Dementia is a common congenial mental disorder with a senior impact on a patient common congenial mental and may cause mental disorder. I do not know much about the dementia of their disorder symptom, the mental outcome of coloring narrative therapy. One stage of supervision in a senior sanatorium with dementia appears greater than normal seniors, and we observe to care through storytelling and mutual communication. I describe several over 65 years old seniors with dementia mentality which a stage of supervision after coloring narrative therapy. It achieved desirable normal mental status along with adequate guide care and mutual communication. In coloring narrative therapy in senior sanatorium the need for mentoring repair for improving mentality not felt by the author due to mutual communication growth that occurred in the coloring narrative therapy course. In view of the above, the supervision associated with several over 65 years old seniors are cheered up, counseling time is reduced and enjoy laughing is an advantage.

Effects of dietary Forsythia suspensa on feed utilization, rumen fermentation, and immune response of Korean native goats (Capra hircus) / Efectos de la adición dietaria de Forsythia suspensa sobre utilización del alimento, fermentación ruminal y respuesta inmune en cabras nativas coreanas (Capra hircus) / Efeitos na dieta pela utilização de Forsythia suspensa nos alimentos, fermentação ruminal e resposta imune em caprinos nativos coreanos (Capra hircus)

Background: plant extracts of Forsythia suspensa, which contain pinoresinol, have been proposed as an alternative to antibiotics due to their antioxidant, anti-inflammatory, and microflora modulating effects. Objective: to evaluate the effects of dietary F. suspensa on feed utilization, rumen fermentation, blood parameters and immune response of Korean native goats (Capra hircus). Methods: a total of nine Korean native goats were assigned to one of three dietary treatments: 1) a basal diet without F. suspensa, 2) a basal diet added with 0.25% F. suspensa, or 3) a basal diet added with 0.50% F. suspensa. A change-over design was used in three consecutive periods to give 9 replicates per treatment. Each period lasted 18 days, including 15 days of adaptation to feed and environmental conditions and three days of total collection of feces and urine. Rumen fluid and blood samples were also collected. Nutrient digestibility, nitrogen retention, ruminal content, and blood metabolites—including immunoglobulins—were measured. Results: F. suspensa supplementation had no effect on nutrient digestibility, whole body nitrogen retention rate, ruminal pH, acetate, propionate, isobutyrate, butyrate, isovalerate, or valerate content (p>0.05). However, F. suspensa supplementation decreased total volatile fatty acids (VFA) concentration compared with the control diet, regardless of F. suspensa concentrations (p<0.05). Goats fed a diet containing 0.25% F. suspensa had greater alkaline phosphatase (ALP) concentration than those fed a control or a diet with 0.50% F. suspensa (p<0.05). Feeding different concentrations of dietary F. suspensa did not influence plasma IgA and IgM levels (p>0.05), although goats receiving both 0.25% and 0.50% F. suspensa diets had greater plasma IgG than those fed the control diet (p<0.05). Conclusion: supplementation of 0.25% F. suspensa significantly decreased total VFA concentrations and increased plasma IgG in Korean native goats, compared with those fed the control diet.

Antecedentes: los extractos de la planta Forsythia suspensa contienen pinoresinol. Dicha planta se ha propuesto como una alternativa a los antibióticos debido a su contenido de antioxidantes, antiinflamatorios y sus efectos moduladores de la microflora. Objetivo: evaluar los efectos dietarios de F. suspensa sobre la utilización del alimento, fermentación ruminal, parámetros sanguíneos y respuesta inmune en cabras nativas coreanas (Capra hircus). Métodos: un total de nueve cabras nativas coreanas fueron asignadas a 1 de 3 tratamientos: (1) una dieta basal sin F. suspensa, (2) una dieta basal con 0,25%, o (3) 0,50% de F. suspensa dietaría en un diseño change-over por tres periodos consecutivos con nueve réplicas por tratamiento. Cada periodo se prolongó por 18 días, incluyendo 15 días de adaptación al alimento y a las condiciones ambientales, y tres días de colección total de heces y orina. Tambien se colectó fluido ruminal y muestras sanguineas. Se midió la digestibilidad de nutrientes, nitrógeno retenido, contenido ruminal y metabolitos sanguíneos —incluyendo inmunoglobulinas—. Resultados: la suplementación con F. suspensa no tuvo efecto sobre la digestibilidad de los nutrientes, la tasa de retención de N, pH ruminal, ni sobre los contenidos de acetato, propionato, isobutirato, butirato, isovalerato o valerato (p>0,05). Sin embargo, la suplementación con F. suspensa disminuyo la concentración total de ácidos grasos volátiles (VFA) en comparacion con la dieta control, sin tener en cuenta las concentraciones de F. suspensa (p<0,05). Las cabras alimentadas con la dieta de 0,25% de F. suspensa tuvieron mayor concentración de fosfatasa alcalina (ALP) que cuando fueron alimentadas con la dieta control o con la de 0,50% de F. suspensa (p<0,05). Aunque la alimentación con diferentes concentraciones de F. suspensa no influyo en los niveles de IgA y IgM en plasma (p>0,05), las cabras que recibieron 0,25 y 0,50% de F. suspensa tuvieron mayor concentración de IgG en plasma que aquellas alimentadas con la dieta control (p<0,05). Conclusiones: la suplementación de 0,25% de F. suspensa disminuyo significativamente la concentración total de VFA e incrementó la IgG en el plasma de las cabras nativas coreanas, en comparación con aquellas que consumieron la dieta control.

Antecedentes: a Forsythiae suspensa é uma planta e seu extrato contém pinoresinol. Tem sido proposta como uma alternativa aos antibióticos existentes, devido ao seu teor de antioxidantes, anti-inflamatórias e efeitos moduladores da microflora, com base em estudos feitos in vivo e in vitro. Objetivo: avaliar os efeitos na dieta da inclusão de F. suspensa no aproveitamento alimentar, fermentação ruminal, parâmetros sanguíneos e resposta imune em caprinos coreanos nativos (Capra hircus). Métodos: um total de nove cabras coreanas nativas foram assignadas a um de três tratamentos na dieta: (1) uma dieta basal sem F. suspensa, (2) uma dieta basal com 0,25% de F. suspensa, ou (3) com 0,50% de F. suspensa na dieta. Se fez um desenho change-over por três períodos consecutivos com nove repetições por tratamento. Cada período de pesquisa consistiu de 18 dias, incluindo 15 dias de adaptação às condições alimentares e ambientais, e três dias de coleta total de fezes e urina. Também foram coletadas amostras de líquido ruminal e sangue. Mediou-se a digestibilidade dos nutrientes, o nitrogênio (N) retido, o conteúdo ruminal, e os parâmetros sanguíneos —incluindo imunoglobulinas—. Resultados: a suplementação com F. suspensa não teve nenhum efeito sobre a digestibilidade dos nutrientes, a taxa de retenção de N, o pH do rúmen, nem sobre os conteúdos de: acetato, propionato, isobutirato, butirato, isovalerato e valerato (p>0,05). No entanto, a suplementação de F. suspensa diminuiu a concentração total de ácidos gordurosos voláteis (AGV) em comparação com a dieta controle, independentemente das concentrações de F. suspensa (p<0,05). As cabras alimentadas com 0,25% F. suspensa na dieta tiveram maiores quantidades da enzima fosfatasse alcalina (ALP) do que quando elas foram alimentadas com a dieta controle ou com 0,50% de F. suspensa (p<0,05). Ainda que a alimentação com diferentes níveis de F. suspensa não influenciou os níveis de IgA e IgM no plasma (p>0,05), as cabras que receberam na dieta 0,25 e 0,50% de F. suspensa tiveram uma maior concentração de IgG no plasma comparadas as cabras alimentadas com a dieta controle (p<0,05). Conclusões: a suplementação com 0,25% e 50% diminuiu significativamente a concentração de AGV e incrementou a concentração em plasma de IgG em cabras nativas coreanas comparadas com aquelas que consumiram a dieta controle.

Relationships among sensory analysis, isoflavone and hexanal contents of soymilk powder

The objective of this work was to study the sensory attributes and their relationships with isoflavones and hexanal contents of soymilks made in laboratory and commercial samples. The laboratory soymilk samples showed cooked grain and cotton candy aroma and cooked grain, malty and sweetness flavor (a mild flavor). The commercial samples presented stronger roasted soy, rancid, sesame seeds and fishy aroma and roasted soy, sesame seeds and bitterness flavor, and bitter taste (closed nose) and starchy texture. No differences were noted among laboratory soymilks, denoting inactivation of lipoxygenases enzymes in the soymilks process. There were differences between the samples prepared in laboratory and commercial soymilks, which was due to several factors related to processing techniques. The hexanal average content was positively associated with the cooked grain aroma and isoflavones was positively associated with the cooked grain and cotton candy aroma, cooked grain, malty and sweetness flavor and starchy texture.

O trabalho foi conduzido com o objetivo de descrever os atributos sensoriais de bebidas de extratos de soja em pó produzidos a partir de cultivares desprovida de lipoxigenases, convencional e tipo hortaliça e dois extratos comerciais e correlacioná-los com as quantidades de isoflavonas e n-hexanal nos extratos em pó. Os extratos de soja em pó obtidos em laboratório foram caracterizados pelos atributos: aroma de feijão cozido e de algodão doce; sabor de grão cozido, de malte e gosto doce sugerindo, sabor suave. Os extratos comerciais apresentaram forte aroma de soja tostada, de ranço, de sementes de gergelim e de peixe; sabor de soja tostada, gosto amargo e de sementes de gergelim; gosto amargo (com nariz preso) e consistência de amido. Não foram observadas diferenças sensoriais entre os extratos produzidos em laboratório, indicando a ocorrência da inativação das enzimas lipoxigenases durante o processamento dos produtos. Contudo, diferenças marcantes entre os extratos obtidos em laboratório e os comerciais quanto aos atributos sensoriais estudados foram encontradas provavelmente, devido às técnicas desconhecidas de processamento utilizadas pelos fabricantes dos produtos comerciais. O teor médio de n-hexanal presente nos extratos de soja comerciais e produzidos em laboratório apresentou correlação positiva e significativa com o atributo aroma de grão cozido, já a quantidade de isoflavonas com aroma de grão cozido e de algodão doce, sabor de grão cozido, de malte, gosto doce e consistência de amido.

Identification of Pseudomonas Aeruginosa Isolated from Burn Patients by Nested Polymerase Chain Reaction: Special reference to comparison with conventional blood culture

PURPOSE: Pseudomonas aeruginosa has emerged as one of the most problematic bacteria in modern hospital settings, and this organism is increasingly isolated as a nosocomial pathogen. Burn patients are particularly susceptible to Pseudomonas infection. Therefore, the accurate and sensitive microbiologic tests are needed for strict management of this prevalent microorganism. METHODS: A nested polymerase chain reaction test based on consecutive amplification of the lipoprotein genes, oprL and oprI, was designed and evaluated, in comparison with the conventional blood culture, for its ability to detect Pseudomonas aeruginosa in clinical materials of burn patients. RESULTS: Positive results of PCR based on oprL gene were observed only for Pseudomonas aeruginosa. All other bacteria (n=4) tested by this amplification method were negative. Also the lowest detection level was 1X101 bacteria per ml of blood samples. In addition, PCR afforded a significantly higher detection rate for Pseudomonas aeruginosa than the conventional blood culture technique in clinical materials of burn patients (25.9% vs. 8.6%). CONCLUSION: This study suggests that the nested PCR technique is highly specific and sensitive test for detectionof Pseudomonas aeruginosa, and therefore it may be a useful adjunct tool, in combination with other conventional techniques, for detection of Pseudomonas aeruginosa infection.

Gait Analysis of Patients with Unilateral Hip Lesion Treated with Total Hip Arthroplasty / 대한정형외과학회잡지

Total hip replacement arthroplasty ( THA ) is a useful treatment method in the patients with avascular necrosis ( AVN ) or degenerative arthritis ( DA ) to relieve pain and recovery of function. Beside pain relief , patients want improvement in gait pattern , which is related with Jeg length discrepancy, range of motion, and muscle power. It could be difficult to analyse the cause of limp accuratelv by the clini-cal observation. Therefore gait analysis will he a good tool for the identification of the factors related to the recovery of patients after the operation. This study was undertaken in an attempt to evaluate the gait characteristics of 16 patients with unilateral hip disease treated with THA. We compared the outcome of qualitative and quantitative analysis of gait and also compared with those of 14 healthy person. The results were as followed : 1. The patients showed short single support time on their painful limb prior to THA , but postoperatively , it was increased to near normal (p<0.05). 2. Preoperatively, the range of hip flexion of the sound side was increased more than those of the normal control and the painful limh. After the THA, it returned to the near normal (p<0.05~). The hip extension of the painful limh uas increased postoperatively (P<0.05) but still it was lower than normai subject. The hip ahduction and internal roiation of sound side was also increased to near normal after THA. In conclusion, great improvement ot the gait characteristics in patients with hip disease after THA was found and this gait improvement can he analyzed quantitatively hy gait analysis.